Obesity and overweight are one of the biggest health problems in the world today. Urbanization, lack of manual labor, massive changes in eating habits are increasing the rate of global obesity. And obesity is on the rise with its associated diseases, such as diabetes, high blood pressure, high cholesterol, heart disease, stroke, arthritis, etc. In medicine, obesity is considered as a serious disease. And it is said to be treated at the appropriate time. Read more about how much fat you need.
Are you obese?
Measurements of the BMI or Body Mass Index are used to determine the ideal weight of an adult male or female. This BMI is calculated by dividing the weight (in kilograms) by the height (in meters) or by the square (square). The normal BMI of an adult is 16.5 to 24.9. If the BMI is above 25, it is overweight. If BMI is above 30, then it is obese. And if the BMI is above 40, it can be called morbid obesity or severe obesity.
Another measure of obesity is the size of the abdomen or waist circumference. Asian men are considered obese if their belly size is more than 90 cm and women are more than 70 cm. Although BMI is normal for Asians with low height, abdominal size is often found to be higher. And this belly fat or abdominal fat is responsible for various diseases.
Why weight increase?
The main reason behind obesity is the imbalance between calorie intake and calorie loss. If we don’t consume or work according to the number of calories we eat daily, those extra calories start accumulating day by day as fat.
Due to rapid urbanization and machine dependence, physical activity is decreasing and people are increasingly consuming high-calorie foods (fast food, desserts, soft drinks). From childhood, bad eating habits and less work put people at risk of obesity. In addition, lack of sports space, sitting at the table during the day in the office, over-reliance on computer-cellphone or car lift, stress, etc. are indirectly responsible for obesity.
Some hormonal disorders may be responsible for obesity. Such as excess of steroid hormones in the body (Cushing’s syndrome), hypothyroidism, polycystic ovary disease etc.
Prolonged use of some drugs also causes weight gain. Such as steroid drugs, insulin, diabetes sulfonylurea urea drugs, some drugs of the antipsychotic group, birth control pills, etc. People with certain genetic diseases (such as Preder Wiley syndrome) may be abnormally obese.
The problem of obesity
Body fat increases the risk of diseases like type-2 diabetes, high blood pressure, heart disease, stroke or paralysis. Obesity causes osteoarthritis in the knee or pain in the waist. The main cause of sleep apnea is obesity. Obesity is even blamed for a number of cancers, including breast cancer and colon cancer. Obesity is also associated with gallstones, infertility, depression and other problems.
Weight loss will be followed by fatigue and constant tiredness. Scientists say that if you can lose 5 to 10 percent of your weight, you will see an unexpected improvement in your blood pressure, blood sugar and blood fat. The risk of cancer will also be reduced.
Treatment of obesity
If the BMI is more than 30, you can take treatment on the advice of a specialist as well as diet and exercise to lose weight. However, if someone has co-morbidity (such as uncontrolled diabetes, high blood pressure or heart disease, sleep apnea), then this treatment can be started on BMI 28.
Three types of OBC treatment are recognized. Oral medications, injections, and surgery. Several types of oral medications (such as orlistat, topiramate, bupropion, etc.) are recognized by the FDA. Liraglutide, Semaglutide, etc. are used in the form of injections. These are actually drugs of the hormone family called Glucagon-like Peptides.
If the BMI is more than 40 or if there is an ancillary disease, the bami is more than 35 but bariatric surgery can be done. Such surgery has started in Bangladesh.
How to lose weight
You can lose weight by reducing daily calorie intake and increasing calorie loss. First of all, you should have motivation and goodwill for that. Do not try to lose weight suddenly or overnight. Plan for the long term. Not only do we need to lose weight, but we also want to maintain that low weight.
- Find out in advance what your ideal weight should be according to height. That is your goal. If the goal is too far away, which means you are overweight, set a goal of losing 5 percent of your weight first.
- Make a calorie chart or diet according to your ideal weight. If you reduce 500 to 600 calories from daily calories, you will start losing weight.
- Not just calories; Food must be chosen carefully. Take complex and fibrous sugars as a source of glucose. Eat good quality protein. Reduce red meat and try to take meat from fish, chicken, pulses, seeds, eggs, milk. The daily intake of fat should be reduced by 20 percent. It is better if that fat is rich in unsaturated fat or omega 3. Marine fish, nuts, etc. have this omega 3. Saturated fats (ghee, butter, dalda, fat on meat) should be eliminated. Any high-calorie food such as fast food, soft drinks, sweets, chocolate, trans fat should be excluded. At least 8 grams of fiber should be taken daily.
- A balanced diet is best for maintaining a low weight for a long time. Popular diets like very low-calorie diet, low carb or keto etc. initially lost weight but after 12 to 24 months no metabolic, cardiovascular benefits were found. And remember, it is not possible to maintain the tendency to lose weight for a long time only through diet. Need exercise with it.
- Exercise or aerobic exercise for 20 to 25 minutes every day or at least 150 minutes a week. Aerobic exercise is fast walking, jogging, swimming, cycling etc.
- There are some benefits to exercising as well as daily endeavors. Walking in the office, taking part in gardening or housework, using the stairs without using the elevator, walking to the market instead of the car, etc. also burn calories. Try to walk ten thousand steps daily.
Author: Tanzina Hossain, Associate Professor, Department of Endocrinology and Metabolism, Green Life Medical College and Hospital, Dhaka.